Sticks (and stones) May Hurt My Bones…

If you have a chronic disease you most probably get stuck a lot. No, not stuck as in a rut, or a routine. I’m talking in a literal way – we all get stuck with needles for blood collection or to start infusion lines. Officially it is called venipuncture, but most of us just call it sticks. And yes they can hurt my bones and more.

My multiple sclerosis disease modifying therapy (DMT) is an infusion drug, which I get regularly, and it requires the placement of an IV line into one of my veins. The last time I went for my clinic appointment I also needed to have blood tests done to check for a particular marker, and then I was off to radiology to have my annual MRI done. I knew in advance that for this visit I would be stuck a lot.

Unfortunately, I am not an easy stick because I have veins which are often hard to locate and it is not uncommon for the needle sticks to initially hit the target, only to have my vein ‘blow’ and the stick needs to be done again in another location. The MS clinic staff knows this from experience and always uses the smallest needles possible to start my drug line.

Knowing I have this problem I try to drink a lot of water before my visits and avoid caffeine. The caffeine dehydrates me and makes it harder to draw blood while water helps to plump up my veins. It also helps if I have kept my arms warm – my cold veins tend to really shrink. Other tips for an easy stick include to relax and breathe. Now I can tell you I start out relaxed but after a couple misses it gets a bit more difficult to be in the moment but I give it my best effort.

If I’m lucky, the nurse and technicians will be on the mark because this type of appointment will require three different uses for needles – 1) my multiple sclerosis drug infusion line. 2) the draw of blood at the lab for testing to check for a particular antibody marker and 3) an IV line for the contrast drug to be injected to look for current disease activity. Unfortunately even though the infusion IV line was left in my arm for the radiology staff to use during my MRI, it was the wrong size line so they had to remove the one to put in a new IV line.

It wasn’t until I got to the radiology lab that the technician used the latest phlebotomy tool available to make these sticks more accurate – they had a vein illuminator. This tool gives the user the closest thing to x-ray vision to locate veins. I love this small hand held gadget because not only is it fun to see my veins lit up, it gives the person with the needle a much better chance of sticking a good spot on the first try.

There are several different types of these illuminators, which are about the size of a telephone, and use either infrared or red led lights to find the veins. There is something about our blood that absorbs the red light and when this device is held above the skin, the light is reflected in a way that allows the person to see the location of the veins under the skin.

If you are like me and are a person who is hard to draw blood from or to start an IV line, you might ask the next time you have to be stuck if they have a vein illuminator. Don’t just sit back and hope for the best on the first attempt. Being a pin cushion with multiple sticks is never fun.

wishing you well,

Laura

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Comments

I’ve actually considered getting a port line put in, just because it’s becoming increasingly challenging to find veins that are not susceptible to rolling or blowing out lately. My guess is that as I complete my 9th year of infusion medications, my 2nd year of monthly lab work, and my 14th year of biannual MRIs, my veins are holding a silent (but painful, and sometimes exasperating) protest.

I’ll definitely look into the vein illuminator, and work to decrease my caffeine intake at least 2-3 days before each of these procedures. Thanks, Laura!

Laura – I have been a good “stick” for years, but donating blood in earlier days and just so many pokes have caused some of my best veins to be less easy to use. My MS Center has its own infusion area with great nurses who are vein conjurers – with heating pads and cranberry juice too, which make it so much nicer. I like your idea of drinking lots of fluid ahead of time and skipping the caffeine (this might be hard for me if not a planned event). Thanks for those ideas!